Pedagogical Practices for Organizing Simula-tion-Based Healthcare Education

Tuulikki Keskitalo

Abstract


Despite the positive findings on the results of simulation-based health-care education, what truly makes it successful remains unclear. We do not know enough about when and how the simulation-based learning environment (SBLE) should be applied. Thus, the specific aim of this thematic-review study was to determine what the facilitators’ pedagogical activities are in the simulation-based education process. For this purpose, the study reviewed 83 previous studies in which the pedagogical practices were explained or examined. Based on the literature review, the pedagogical practices have been clearly linked to facilitators’ activities before, during, or after simulation. Most of the research has focused on facilitators’ activities during simulation-based education, especially during the debriefing phase. Some studies have examined pre-simulation activities, but the research concentrating on facilitators’ post-simulation activities is limited. All in all, this thematic literature review provided insights on the successful pedagogical practices for implementing the simulation-based health-care education process. To further develop simulation-based health-care education and to optimize the use of such a learning environment, scholars should describe facilitators’ and learners’ activities more accurately; and they should use more rigorous research methods to analyze the teaching and the learning activities. Furthermore, such knowledge should be synthesized and used to develop pedagogical models and methods for simulation-based healthcare education and to integrate them into various learning contexts.

https://doi.org/10.26803/ijlter.21.4.1


Keywords


learning theories; pedagogy; facilitation; practices; methods; thematic literature review

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References


Alinier, G. (2011). Developing high-fidelity healthcare simulation scenarios: A guide for educators and professionals. Simulation Gaming, 42(1), 9–26. https://doi.org/10.1177/1046878109355683

Allvin, R., Berndtzon, M., Carlzon, L., Edelbring, S., Hult, H., Hultin, M. et al. (2017). Confident but not theoretically grounded: Experienced simulation educators’ perceptions of their own professional development. Advances in Medical Education and Practice, 8, 99–108. https://doi.org/10.2147/AMEP.S123517

Arthur, C., Levett-Jones, T., & Kable, A. (2013). Quality indicators for the design and implementation of simulation experiences: A Delphi study. Nurse Education Today, 33, 1357–1361. https://doi.org/10.1016/j.nedt.2012.07.012

Attride-Stirling, J. (2001). Thematic networks: An analytic tool for qualitative research. Qualitative research, 1(3), 385–405. https://doi.org/10.1177/146879410100100307

Barab, S., & Squire, K. (2004). Design-based research: Putting a stake in the ground. Journal of the Learning Sciences, 13, 1–14. https://doi.org/10.1207/s15327809jls1301_1

Batchelder, A. J., Steel, A., Mackenzie, R., Hormis, A. P., Daniels, T. S., & Holding, N. (2009). Simulation as a tool to improve the safety of pre-hospital anaesthesia – A pilot study. Journal of the Association of Anaesthetists of Great Britain and Ireland, 64, 978–983. https://doi.org/10.1111/j.1365-2044.2009.05990.x

Beauchesne, M. A., & Douglas, B. (2011). Simulation: Enhancing Pediatric, Advanced, Practice Nursing Education. Newborn & Infant Nursing Reviews, 11(1), 29–34. https://doi.org/10.1053/j.nainr.2010.12.009

Bearman, M., Greenhill, J., & Nestel, D. (2019). The power of simulation: a large-scale narrative analysis of learners’ experiences. Medical Education, 53, 369–379. https://doi.org/ 10.1111/medu.13747

Bearman, M., O’Brien, R., Anthony, A., Civil, I., Flanagan, B., Jolly, B., Birks, D., Langcake, M., Molloy, E., & Nestel, D. (2014). Learning surgical communication, leadership and teamwork through simulation. Journal of Surgical Education, 69(2), 201–206. https://doi.org/10.1016/j.jsurg.2011.07.014

Berragan, L. (2011). Simulation: An effective pedagogical approach for nursing? Nurse Education Today, 31, 660–663. https://doi.org/10.1016/j.nedt.2011.01.019

Bland, A., Topping, A., & Wood, B. (2011). A concept analysis of simulation as a learning strategy in the education of undergraduate nursing students. Nurse Education Today, 31, 664–670. https://doi.org/10.1016/j.nedt.2010.10.013

Braun, V., & Clarke, V. (2014). What can “thematic analysis” offer health and wellbeing researchers? International Journal of Qualitative Studies on Health and Well-being 9(1), 1–2. https://doi.org/10.3402/qhw.v9.26152

Brewer, E. P. (2011). Successful techniques for using human patient simulation in nursing education. Journal of Nursing Scholarship, 43(3), 311–317. https://doi.org/10.1111/j.1547-5069.2011.01405.x

Burden, A. R., Pukenas, E. W., Deal, E. R., Coursin, D. B., Dodson, G. M., Staman, G. W., Gratz, I., & Trojman, M. C. (2014). Using simulation education with deliberate practice to teach leadership and recourse-management skills to senior residents’ code leaders. Journal of Graduate Medical Education, 9, 463–469. https://doi.org/10.4300/JGME-D-13-00271.1

Cant, R. P., & Cooper, S. J. (2009). Simulation-based learning in nurse education: Systematic review. Journal of Advanced Nursing, 39(2), 3–15. https://doi.org/10.1111/j.1365-2648.2009.05240.x

Chakravarthy, B., Ter Haar, E., Bhat, S. S., McCoy, C. E., Denmark, T. K., & Lotfipour, S. (2011). Simulation in medical school education: Review for emergency medicine. The Western Journal of Emergency Medicine, 12(4), 461–466. https://doi.org/10.5811/westjem.2010.10.1909

Chee, J. (2014). Clinical simulation using deliberate practice in nursing education: A Wilsonian concept analysis. Nurse Education in Practice, 14, 247–252. https://doi.org/10.1016/j.nepr.2013.09.001

Cheng, A., Eppich, W., Grant, V., Sherbino, J., Zendejas, B., & Cook, D. A. (2014). Debriefing for technology-enhanced simulation: A systematic review and meta-analysis. Medical Education, 48, 657–666. https://doi.org/10.1111/medu.12432

Cianciolo, A.T, & Regehr, G. (2019). Learning theory and educational intervention: producing meaningful evidence of impact through layered analysis. Academic Medicine, 94(6), 789–794. https://doi.org/10.1097/ACM.0000000000002591

Clapper, T. C. (2010). Beyond Knowles: What those conducting simulation need to know about adult learning theory. Clinical Simulation in Nursing, 6, e7–e14. https://doi.org/10.1016/j.ecns.2009.07.003

Cook, D. A., Hamstra, S. J., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, J. P., & Hatala, R. (2013). Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Medical Teacher, 35, 844–875. https://doi.org/10.3109/0142159X.2012.714886

Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hamstra, S. J. (2011). Technology-enhanced simulation for health professions education: A systematic review and meta-analysis. The Journal of the American Medical Association (JAMA), 306(9), 979–988. https://doi.org/10.3109/0142159X.2012.714886

Davies, J., Nathan, M., & Clarke, D. (2012). An evaluation of a complex simulated scenario with final year undergraduate children’s nursing students. Collegian, 19, 131–138. https://doi.org/10.1016/j.colegn.2012.04.005

Dieckmann, P. (2009). Simulation settings for learning in acute medical care. In P. Dieckmann (Ed.), Using Simulations for Education, Training and Research (pp. 40–138. Pabst Science Publishers.

Dieckmann, P., Friis, S. M., Lippert, S. M. F., & Østergaard, D. (2012). Goals, success factors, and barriers for simulation-based learning: A qualitative interview study in healthcare. Simulation & Gaming, 43(5), 627–647. https://doi.org/10.1177/1046878112439649

Dieckmann, P., Gaba, D., & Rall, M. (2007). Deepening the theoretical foundations of patient simulation as social practice. Simulation in Healthcare, 2, 183–193. https://doi.org/10.1097/SIH.0b013e3180f637f5

Dieckmann, P., & Rall, M. (2007). Simulators in anaesthetic training to enhance patient safety. In J. N. Cashman & R. M. Grounds (Ed.), Recent advances in anesthesia & intensive care 24 (pp. 211-232). Cambridge University Press.

Dufrene, C., & Young, A. (2014). Successful debriefing – Best methods to achieve positive learning outcomes: A literature review. Nurse Education Today, 34(3), 372–376. https://doi.org/10.1016/j.nedt.2013.06.026

Fanning, R. M., & Gaba, D. M. (2007). The role of debriefing in simulation-based learning. Simulation in Healthcare, 2, 115–125. https://doi.org/10.1097/SIH.0b013e3180315539

Franklin, A. E., Burns, P., & Lee, C. S. (2014). Psychometric testing on the NLN Student Satisfaction and Self-Confidence in Learning, Simulation Design Scale, and Educational Practices Questionnaire using a sample of pre-licensure novice nurses. Nurse Education Today, 34(10), 1298–1304. https://doi.org/10.1016/j.nedt.2014.06.011

Gaba, D. (2004). The future vision of simulation in health care. Quality and Safety in Healthcare, 13(1), 2–10. https://doi.org/10.1136/qshc.2004.009878

Gaba, D.M., & DeAnda, A. (1988). Comprehensive anesthesia simulation environment: re-creating the operating room for research and training. Anesthesiology, 69(3), 387–394. https://doi.org/10.1097/00000542-198809000-00017

Garden, A. L., Le Fevre, D. M., Waddington, H. L., & Weller, J. M. (2015). Debriefing after simulation-based non-technical skill training in healthcare: A systematic review of effective practice. Anaesthesia Intensive Care, 43(3), 300–308. https://doi.org/10.1177/0310057X1504300303

Gardner, R. (2013). Introduction to debriefing. Seminars in Perinatology, 37, 166–174. https://doi.org/10.1053/j.semperi.2013.02.008

Garrett, B. M., MacPhee, M., & Jakcson, C. (2011). Implementing high-fidelity simulation in Canada: Reflections on 3 years of practice. Nurse Education Today, 31, 671–676. https://doi.org/10.1016/j.nedt.2010.10.028

Goldberg, A., Silverman, E., Katz, D., Lin, H. M., Levine, A., & DeMaria, S. (2015). Learning through simulated independent practice leads to better future performance in a simulated crisis than learning through simulated supervised practice. British Journal of Anaesthesia, 114(5), 794–800. https://doi.org/10.1093/bja/aeu457

Gough, S., Hellaby, M., Jones, N., & MacKinnon, R. (2012). A review of undergraduate interprofessional simulation-based education (IPSE). Collegian, 19, 153–170. https://doi.org/10.1016/j.colegn.2012.04.004

Harder, N. B. (2009). Evolution of simulation use in healthcare education. Clinical Simulation in Nursing, 5, 169–172. https://doi.org/10.1016/j.ecns.2009.04.092

Hope, A., Garside, J., & Prescott, S. (2011). Rethinking theory and practice: Pre-registration student nurses experiences of simulation teaching and learning in the acquisition of clinical skills in preparation for practice. Nurse Education Today, 31, 711–715. https://doi.org/10.1016/j.nedt.2010.12.011

Hämäläinen, R., & Vähäsantanen, K. (2011). Theoretical and pedagogical perspectives on orchestrating creativity and collaborative learning. Educational Research Review, 6, 169–184. https://doi.org/10.1016/j.edurev.2011.08.001

Irby, D. M. (1995). Teaching and learning in ambulatory care settings: A thematic review of the literature. Academic Medicine, 70(10), 898–931. https://doi.org/10.1097/00001888-199510000-00014

Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Gordon, D. L., & Scalese R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 27, 10–28. https://doi.org/10.1080/01421590500046924

Issenberg, S. B., Ringsted, C., Østergaard, D., & Dieckmann, P. (2011). Setting a research agenda for simulation-based healthcare education. A synthesis of the outcome from an Utstein-style meeting. Simulation in Healthcare, 6, 155–167. https://doi.org/10.1097/SIH.0b013e3182207c24

Jarvill, M., & Krebs, H. (2018). Effect on Expert Role Modeling on Skill Performance in Simulation. Clinical Simulation in Nursing, 24, 25–29. https://doi.org/10.1016/j.ecns.2018.08.005

Jeffries, P. (ed.) (2007). Simulation in nursing education. New York: National League for Nursing.

Ker, J. (2012). Review: The challenges of developing and evaluating complex care scenarios using simulation in nurse education. Journal of Research in Nursing, 17, 346–347. https://doi.org/10.1177/1744987112449970

Keskitalo, T. (2015a). Designing a pedagogical model simulation-based healthcare education. Acta Universitatis Lapponiensis 299. Rovaniemi, Lapland University Press.

Keskitalo, T. (2015b). Theoretical and pedagogical underpinnings of simulation-based healthcare and medical education. In S. Carliner, C. Fulford & N. Ostashewski (Ed.), Proceedings of EdMedia: World Conference on Educational Media and Technology 2015 (pp. 1191-1199). Association for the Advancement of Computing in Education (AACE).

Keskitalo, T., Ruokamo, H. & Gaba, D. (2014). Towards Meaningful Simulationbased Learning with Medical Students and Junior Physicians. Medical teacher, 36i(3), 230-239. https://doi.org/10.3109/0142159X.2013.853116

Kihlgren, P., Spannagel, L., & Dieckmann, P. (2015). Investigating novice doctors’ reflections in debriefings after simulation scenarios. Medical Teacher, 37, 437–443. https://doi.org/ 10.3109/0142159X.2014.956054

Kirkpatrick, D. L. (1998). Evaluating Training Programs: The Four Levels. (2nd ed.). Berrett-Koehler.

Kneebone, R. (2005). Evaluating clinical simulations for learning procedural skills: A theory-based approach. Academic Medicine, 80(6), 549–553. https://doi.org/10.1097/00001888-200506000-00006

Knowles, M. S., Holton, E. F., & Swanson, R. A. (1998). The adult learner. (5th ed.). Houston, TX: Gulf Publishing Company.

Kolb, D. A. (1984). Experiential learning: Experiences as a source of learning and development. Prentice Hall.

Konia, M. & Yao, A. (2013). Simulation a new educational paradigm? The Journal of Biomedical Research, 27(2), 75–80. https://doi.org/10.7555/JBR.27.20120107

Lai, A., Haligua, A., Bould, M. D., Everett, T., Gale, M., Pigford, A-A., & Boet, S. (2016). Learning crisis resource management: Practicing versus observational role in simulation training – A randomized controlled trial. Anaesthesia Critical Care and Pain Medicine, 35(4), 275–281. https://doi.org/10.1016/j.accpm.2015.10.010

Laksov, K. B., Nikkola, M., & Lonka, K. (2008). Does teachers’ thinking match teaching practice? A study of basic science teachers. Medical Education, 42, 143–151. https://doi.org/10.1111/j.1365-2923.2007.02985.x

LeBlanc, V. R., & Posner, G. D. (2022). Emotions in simulation-based education: friends or foes for learning? Advances in Simulation7(3). https://doi.org/10.1186/s41077-021-00198-6

Leigh, G., & Steuben, F. (2018). Setting Learners up for Success: Pre-simulation and Pre-briefing Strategies. Teaching and Learning in Nursing, 13, 185–189. http://dx.doi.org/10.1016/j.teln.2018.03.004

Levett-Jones, T., & Lapkin, S. (2014). A systematic review of the effectiveness of simulation debriefing in health professional education. Nurse Education Today, 34, 58–63. https://doi.org/10.1016/j.nedt.2013.09.020

Littlewood, K. (2011). High fidelity simulation as a research tool. Best Practice & Research Clinical Anaesthesiology, 25, 473–487. https://doi.org/ 10.1016/j.bpa.2011.08.001

McCoy, E., Menchine, M., Anderson, C., Kollen, R., Langdorf, M. I., & Loftipour, S. (2011). Prospective randomized crossover study of simulation vs. didactics for teaching medical students the assessment and management of critically ill patients. The Journal of Emergency Medicine, 40(4), 448–455. https://doi.org/10.1016/j.jemermed.2010.02.026

McGaghie, W. C., Draycott, T. C., Dunn, W. F., Lopez, C. M., & Stefanidis, D. (2011). Evaluating the impact of simulation on translational patient outcomes. Simulation in Healthcare, 6(7), 42–47. https://doi.org/10.1097/SIH.0b013e318222fde9

McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706–711. https://doi.org/10.1097/ACM.0b013e318217e119

Moll-Khoswari, P., Zöllner, C., Cencin, N., & Schulte-Uentrop, L. (2021). Flipped learning enhances non-technical skill performance in simulation-based education: a randomised controlled trial. BMC Medical Education, 21(353). https://doi.org/10.1186/s12909-021-02766-w

Motola, I., Devine, L. A., Chung, H. S., Sullivan, J. E., & Issenberg, S. B. (2013). Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82. Medical Teacher, 35(10), 1511–1530. https://doi.org/10.3109/0142159X.2013.818632

Nguyen, N., Elliot, J. O., Watson, W. D., & Dominguez, E. (2015). Simulation improves nontechnical skills performance of residents during the perioperative and intraoperative phases of surgery. Journal of Surgical Education, 72(5), 957–963. https://doi.org/10.1016/j.jsurg.2015.03.005

Norman, G., Dore, K., & Grierson, L. (2012). The minimal relationship between simulation fidelity and transfer of learning. Medical Education, 46, 636–647. https://doi.org/10.1111/j.1365-2923.2012.04243.x

Nyström, S., Dahlberg, J., Edelbring, S., Hult, H., & Abrandt-Dahlgren, M. (2016). Debriefing practices in interprofessional simulation with students: A socio-material perspective. BMC Medical Education, 16, 148.

Paige, J. B., & Daley, B. J. (2009). Situated cognition: A learning framework to support and guide high-fidelity simulation. Clinical Simulation in Nursing, 5, 97–103. https://doi.org/10.1016/j.ecns.2009.03.120

Power, T., Virdun, C., White, H., Hayes, C., Parker, N., Kelly, M., Disler, R., & Cottle, A. (2016). Plastic with personality: Increasing student engagement with manikins. Nurse Education Today, 38, 126–131. https://doi.org/10.1016/j.nedt.2015.12.001

Ramsingh, D., Alexander, B., Khanhvan, L., Williams, W., Canales, C., & Cannesson, M. (2014). Comparison of the didactic lecture with the simulation/model approach for the teaching of a novel perioperative ultrasound curriculum to anesthesiology residents. Journal of Clinical Anaethesia, 26, 443–454. https://doi.org/10.1016/j.jclinane.2014.01.018

Rivière, E., Saucier, D., Lafleur, A., Lacasse, M., & Chiniara, G. (2018). Twelve tips for efficient procedural simulation. Medical Teacher, 40(7). 743–751. https://doi.org/10.1080/0142159X.2017.1391375

Rudolph, J. W., Simon, R., Raemer, D. B., & Eppich, W. J. (2008). Debriefing as formative assessment: Closing performance gaps in medical education. Academic Emergency Medicine, 15(11), 1010–1016. https://doi.org/ 10.1111/j.1553-2712.2008.00248.x

Rystedt, H., & Sjöblom, B. (2012). Realism, authenticity, and learning in healthcare simulations: Rules of relevance and irrelevance as interactive achievements. Instructional Science, 40, 785–798. https://doi.org/10.1007/s11251-012-9213-x

Schroedl, C. J., Corbridge, T. C., Cohen, E. R., Fakhran, S. S., Schimmel, D., McGaghie, W. C., & Wayne, D. B. (2012). Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial. Journal of Critical Care, 27, e7–e13. https://doi.org/ 10.1016/j.jcrc.2011.08.006

Solnick, A., & Weiss, S. (2007). High fidelity simulation in nursing education: A review of the literature. Clinical Simulation in Nursing Education, 3, 41–45. https://doi.org/10.1016/j.ecns.2009.05.039

Steinwachs, B. (1992). How to facilitate debriefing. Simulation & Gaming, 23(2), 186–192. https://doi.org/10.1177/1046878192232006

Swamy, M., Bloomfield, T. C., Thomas, R. H., Singh, H., & Searle, R. F. (2013). Role of SimMan in teaching clinical skills to preclinical medical students. BMC Medical Education, 13(20). https://doi.org/10.1186/1472-6920-13-20

Tremblay, M-L., Leppink, J., Leclerc, G., Rethans, J-J., & Dolmans, D. H. J. M. (2019). Simulation-based education for novices: complex learning tasks promote reflective practice. Medical Education, 53, 380–389. https://doi.org/ 10.1111/medu.13748

Tutticci, N., Ryan, M., Coyer, F., & Lewis, P. (2018). Collaborative facilitation of debrief after high-fidelity simulation and its implications for reflective thinking: student experiences. Studies in Higher Education, 43(9), 1654–1667. https://doi.org/10.1080/03075079.2017.1281238

Van Soeren, M., Devlin-Cop, S., MacMillan, K., Baker, L., Egan-Lee, E., & Reeves, S. (2011). Simulated interprofessional education: An analysis of teaching and learning processes. Journal of Interprofessional Care, 25(6), 434–440. https://doi.org/10.3109/13561820.2011.592229

Vygotsky, L. (1978). Mind in society: The development of higher psychological processes. Harvard University Press.

Walton, J., Chute, E., & Ball, L. (2011). Negotiating the role of the professional nurse: The pedagogy of simulation: A grounded theory study. Journal of Professional Nursing, 27(5), 299–310. https://doi.org/10.1016/j.profnurs.2011.04.005

Wang, E. E. (2011). Simulation and adult learning. Disease a Month, 57, 664–678. https://doi.org/10.1016/j.disamonth.2011.08.017

Weller, J. M. (2004). Simulation in undergraduate medical education: Bridging the gap between theory and practice. Medical Education, 38, 32–38. https://doi.org/10.1111/j.1365-2923.2004.01739.x

Yue, Y. L., Mio, L. A., Wai, I. N., & Si C. W. (2022). High-fidelity simulation in undergraduate nursing education: A meta-analysis. Nurse Education Today, 111. https://doi.org/10.1016/j.nedt.2022.105291.

Zigmont, J. J., Kappus, L. J., & Sudikoff, S. N. (2011). Theoretical foundations of learning through simulation. Seminars in Perinatology, 35, 47–51. https://doi.org/10.1053/j.semperi.2011.01.002

Ziv, A., Small, S. D., & Wolpe, P. R. (2000). Patient safety and simulation-based medical education. Medical Teacher, 22(5), 489–495. https://doi.org/10.1080/01421590050110777


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